Promoting and Protecting the City's Health

Health Department Releases Data Briefs on Psychiatric Hospitalizations among Children and Adults in New York City

Rate of psychiatric hospitalization among adults remained stable from 2004 to 2013

Psychiatric hospitalizations have increased among youth over the past 14 years

Psychiatric hospitalization rates are highest in poorer neighborhoods

June 15, 2016 – The Health Department today released two Epi Data Briefs examining psychiatric hospitalizations among children and adolescents, and psychiatric hospitalizations among adults in New York City. One brief looks at hospitalizations for mental disorders among children aged 3 to 12 and adolescents aged 13 to 17 in New York City. In 2013, 11 percent of all hospitalizations among children and adolescents were for psychiatric conditions, compared with 10 percent reported nationally. Between 2000 and 2013, there was an average of 1,664 annual psychiatric hospitalizations among children, and an average of 3,001 hospitalizations among adolescents in NYC. According to the data, children living in very high-poverty neighborhoods were more than twice as likely to be hospitalized as children living in low-poverty neighborhoods (224 vs. 94 per 100,000 children). Rates for adolescents ranged from 597 per 100,000 for those living in medium-poverty neighborhoods to 732 per 100,000 for those living in very high-poverty neighborhoods.

The second brief looks at psychiatric hospitalizations among adults in NYC. In 2013, the hospitalization rate was 676 per 100,000 adults. Psychiatric hospitalization rates are highest in poorer neighborhoods. About one in 11 adults (9 percent) hospitalized for mental illness in NYC in 2013 had three or more psychiatric hospitalizations during the calendar year. Psychiatric hospitalizations among these adults accounted for approximately a quarter (26 percent) of all psychiatric hospitalizations. The rate of psychiatric hospitalization readmissions within 30 days to any NYC hospital was 13 percent. The rate of readmission within 90 days was 22 percent.

The Epi Data briefs provide access to Health Department data on specific topics to help to identify gaps and trends. Variability in hospitalization rates by neighborhood poverty status may be attributed variously to patient-related factors (e.g., care seeking) and system factors, such as access to care and quality of care. Both complete data briefs can be found on nyc.gov/health.

“No child should be hospitalized because they are poor,” said First Lady Chirlane McCray, who spearheads the city’s efforts on mental health. “ThriveNYC works to intervene early, before problems become more serious, and to bring desperately needed mental health services closer to home in high-need neighborhoods. By working with communities, to create a culture of early intervention and increase access to services, we can build healthier children and a stronger New York City.”

“These new data highlight the impact of mental illness across the life course. Mental illness is not restricted to any one age group, and for all age groups, the burden of hospitalization falls disproportionately on poor neighborhoods,” said Health Commissioner Dr. Mary T. Bassett. “More must be done to connect New Yorkers to the array of mental health services available, a goal of ThriveNYC. By acting early and promoting treatment in community settings, we can begin to address these treatment gaps. The disparities in psychiatric hospitalizations among New Yorkers in high-poverty neighborhoods underscore the need to expand access to community and non-hospital based sources of care, as well as more prevention opportunities for all New Yorkers.”

“This information tells us we have work to do to meet needs in the community. One in five of our children who are psychiatrically hospitalized face that experience again within a year. This will mean working with schools, providers, communities and families so that fewer children are in situations where hospitalization seems to be the only option. As we are now investing more in solutions for some of our most seriously ill adults, we will also keep our focus on being able to act much earlier,” said Executive Deputy Commissioner Dr. Gary Belkin.

“This data brief on psychiatric hospitalizations reflects troubling disparities between neighborhoods,” said Council Member Corey Johnson, Chair of the Committee on Health. “The fact that poorer neighborhoods have the highest psychiatric hospitalizations rates shows how much work there is to do with respect to addressing access to care, structural barriers and other factors. I thank Commissioner Dr. Mary Bassett and the Department of Health & Mental Hygiene for releasing this important data.”

The City has made mental health awareness and access to services a top policy priority. With ThriveNYC, an unprecedented set of 54 initiatives, the Health Department is raising awareness about the need to seek help while increasing mental health services across the city.

To prevent the use of mental health related hospital emergency departments among children, adolescents and adults, the City has invested in several programs, including:

-- The DOE School-Based Mental Health Program. This program offers a range of services to students who have emotional and behavioral difficulties in City schools. On-site services, mobile response teams and trainings, provide comprehensive support to children and adolescents.

-- Mobile crisis teams. These teams consist of mental health professionals who respond to any person in New York City who is experiencing or is at risk of a psychological crisis and requires mental health intervention. Referrals to the mobile crisis teams are made by calling 1-800-LIFENET.

-- Home-Based Crisis Intervention (HBCI) offers an alternative to out-of-home placement for youth experiencing psychiatric distress. The program is designed to provide short-term intensive in-home crisis intervention to families in crisis due to the imminent risk of their child being hospitalized at an inpatient psychiatric unit.

-- The New York City Supportive Transition and Recovery Team (NYC START). Designed to improve the connection to community-based care among New Yorkers experiencing a first episode of psychotic illness, this program offers care coordination, psycho-education and support services to young adults who have been hospitalized for the first time due to psychosis. The team uses a Critical Time Intervention case management model and “shared decision making” approach to ensure linkage to care, connect clients to specialized and recovery-oriented services, and support their transition back into the community.

The Health Department will continue to conduct surveillance on the use of hospital emergency departments and inpatient hospitalizations for psychiatric reasons among children, adolescents, and adults. The Department will also further research into understanding the diagnosis of ADHD as a primary cause for hospitalization among children, and continue research to better understand the needs of adults who are discharged from a psychiatric hospitalization and factors that put individuals at risk for rehospitalization.